Nasogastric tube displacement to the right as a sign of acute traumatic rupture of the thoracic aorta

A study was undertaken to determine the accuracy of nasogastric tube (NGT) displacement to the right as a sign of acute traumatic rupture of the thoracic aorta (ATRTA). In 14 patients with confirmed ATRTA, the sensitivity of NGT displacement to the right was 70% using measurement of displacement from the midline on chest radiography. Two control groups, comprising victims of vehicular trauma and patients with no recent history of trauma, showed significant percentages of false positive findings for ATRTA based on NGT displacement. The presence of this radiographic sign is highly suspicious for this lethal injury; however, the absence of displacement cannot be used to exclude the diagnosis of ATRTA.